摘要
目的比较达格列净联合二甲双胍和西格列汀联合二甲双胍治疗超重及肥胖2型糖尿病的疗方式分为达格列净组(107例)和西格列汀组(110例)。治疗24周后,比较治疗前后的空腹血糖(FBG)、糖化血红蛋白(HbA1c)和其他相关代谢指标,记录用药期间不良反应发生情况。结果治疗24周后,(1)两组患者的FBG、HbA1c、血脂和血尿酸均较用药前下降(均P <0.05),但两组间差异无统计学意义(均P>0.05)。(2)达格列净组体质量和腰围、收缩压和舒张压均较用药前下降(均P <0.05)。(3)达格列净组泌尿生殖道感染增加,并出现血糖正常的糖尿病酮症酸中毒,不良反应多于西格列汀组,差异有统计学意义(P <0.05)。结论达格列净联合二甲双胍与西格列汀联合二甲双胍对超重及肥胖2型糖尿病患者的降糖能力相似,达格列净有效降低患者体质量、腰围和血压,但其泌尿生殖道感染及糖尿病酮症酸中毒风险值得注意。西格列汀安全性良好。
Objective This retrospective study was aimed to compare the efficacy and safety of dapa⁃gliflozin combined with metformin and sitagliptin combined with metformin in the treatment of overweight and obese type 2 diabetes.Methods A total of 217 patients with type 2 diabetes in whom the body mass index(BMI)>25 kg/m2 were divided into dapagliflozin group(n=107)and sitagliptin group(n=110)according to different treatment options.After 24⁃week treatment,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c)and other related metabolic indicators before and after treatment were compared.The adverse reactions during medication were recorded.Results After 24⁃week treatment,FBG,HbA1c,blood lipid and uric acid were decreased in both groups(P<0.05),but there was no statistical difference between the two groups(P>0.05).Body weight,waist circumference,systolic and diastolic blood pressure were decreased in the dapagliflozin group(P<0.05).Urogenital tract infection was increased in the dapagliflozin group,and diabetic ketoacidosis with normal blood sugar occurred,with more adverse reactions than that in the sitagliptin group,showing statistical difference(P<0.05).Conclusion Dapagliflozin combined with metformin and sitagliptin combined with metformin had the same hypoglycemic effect on overweight and obese patients with type 2 diabetes.Dapagliflozin could effectively reduce the body weight,waist circumference and blood pressure,but its risk of urogenital tract infection and diabetic ketoacidosis should be noticed.In terms of safety,Sitagliptin is much better than Dapagliflozin.
作者
张咪
梁伟
许祥
ZHANG Mi;LIANG Wei;XU Xiang(Department of Endocrinology and Metabolism,Shenzhen Hospital,the Uni-versity of Hong Kong,Shenzhen 518053,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2021年第9期1182-1186,共5页
The Journal of Practical Medicine
关键词
达格列净
西格列汀
2型糖尿病
二甲双胍
肥胖
dapagliflozin
sitagliptin
type 2 diabetes mellitus
metformin
obesity
